Surgical Procedures for Heart Failure

Surgical procedures are used to treat heart failure. They may also be used to treat or improve other heart conditions that contribute to your heart failure.

Treating Heart Failure

If your heart failure is not responding to medical therapy, you may need a surgical procedure. These procedures will help your heart to work more efficiently and help minimize further damage. These include:

Biventricular Cardiac Pacemaker

People with heart failure who also have heart
arrhythmias
may benefit from pacemakers. Controlling the rhythm of the heart in a more normal fashion can help the heart pump more efficiently. People with dilated cardiomyopathies, unresponsive to medical therapy, may benefit from a biventricular cardiac pacemaker. This type of pacemaker sends carefully timed electrical impulses to the heart’s lower chambers. The pacemaker is implanted in the chest and connected to the heart.

This is a device that can be implanted in your chest. People with heart failure are more prone to certain heart arrhythmias that put them at risk for sudden cardiac death. ICDs are implanted in people to prevent such arrhythmias from occurring.

This is a mechanical pump that can be implanted in your chest. It assists the heart's pumping. This device is sometimes referred to as a bridge to transplant, since it can be used to maintain people awaiting heart transplants. This device can also be used as permanent treatment in people who:

Are not candidates for transplant

Do not respond to medical therapy

Have a low risk of surviving one year

LVAD has shown promising success in extending life and eliminating the need for a heart transplant in some people.

Heart Transplant

When a heart is damaged to the point that no other therapies work and a person is at risk of dying, a heart transplant may be considered. This is reserved for the most severe cases of heart failure.
There are number of conditions that may limit a person’s ability to receive a heart transplant. People who are eligible for a heart transplant are placed on a waiting list for a donor heart. Waiting times for a heart can range from days to months, which are dependent on several factors.

During the waiting period, people who need transplants continue with treatment until a donor becomes available. Depending on the severity of the heart failure, and treatment response, it is possible to receive an implantable medical device during this time.

Close medical follow-up is essential after a heart transplant. After surgery, there is an increased risk for a number of different health conditions, including rejection of the transplant, infections, and malignancies. Most people, however, return to normal activities, including work and exercise. A specific rehabilitation program may be suggested to speed recovery and restore cardiovascular health.

Treating
Other Heart
Conditions

Surgery can help repair or improve any underlying heart conditions that may contribute to heart failure. These include:

Heart valve replacement:
Improves the blood flow inside the heart, but has not been shown to improve heart failure survival. It may be considered for some situations.

Coronary artery graft bypass (CABG):
More commonly known as open-heart or bypass surgery. Grafted veins from the legs are used to go around clogged arteries that feed the heart muscle. This will improve blood flow to the heart muscle and help it work more efficiently.

Revision Information

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.

ACCF/AHA Guidelines for the Diagnosis and Management of Heart Failure in Adults. A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines.
Circulation. 2009;119(14):1977-2016.